NUR 265 EXAM 3 NEWEST EXAM COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED
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Which prescribed medication would the nurse expect will have the most
rapid effect on a patient admitted to the emergency department in thyroid
storm?
a. Iodine
b. Methimazole
c. Propylthiouracil
d. Propranolol (Inderal) ✔✔CORRECT ANSWER✔✔ANS: D
B-Adrenergic blockers work rapidly to decrease the cardiovascular
manifestations of thyroid storm. The other medications take days to weeks
to have an impact on thyroid function.
Which assessment finding for an adult admitted with Graves' disease
requires the most rapid intervention by the nurse?
a. Heart rate 136 beats/min
b. Severe bilateral exophthalmos
c. Temperature 103.8F (40.4C)
d. Blood pressure 166/100 mm Hg ✔✔CORRECT ANSWER✔✔ANS: C
,The patient's temperature indicates that the patient may have thyrotoxic
crisis and that interventions to lower the temperature are needed
immediately. The other findings also require intervention but do not indicate
potentially life-threatening complications.
A patient has just arrived in the postanesthesia recovery unit (PACU) after a
thyroidectomy. Which information about the patient is most important to
communicate to the surgeon?
a. Difficult to awaken
b. Increasing neck swelling
c. Reports 7/10 incisional pain
d. Cardiac rate 112 beats/min ✔✔CORRECT ANSWER✔✔ANS: B
The neck swelling may lead to respiratory difficulty, and rapid intervention is
needed to prevent airway obstruction. The incisional pain would be treated
but is not unusual after surgery. A heart rate of 112 beats/min is not unusual
in a patient who has been hyperthyroid and has just arrived in the PACU
from surgery. Sleepiness in the immediate postoperative period is expected.
Which assessment finding in a patient with a history of bilateral
adrenalectomy requires the most rapid action by the nurse?
a. The blood glucose is 192 mg/dL.
b. The lungs have bibasilar crackles.
c. The patient reports 6/10 incisional pain.
d. The blood pressure (BP) is 88/50 mm Hg. ✔✔CORRECT ANSWER✔✔ANS:
D
,The decreased BP indicates possible adrenal insufficiency. The nurse would
immediately notify the health care provider so that corticosteroid
medications can be administered. The nurse would also address the elevated
glucose, incisional pain, and crackles with appropriate collaborative or
nursing actions, but prevention and treatment of acute adrenal insufficiency
are the priorities after adrenalectomy.
A patient is admitted with diabetes insipidus. Which action will be
appropriate for the registered nurse (RN) to delegate to an experienced
licensed practical/vocational nurse (LPN/VN)?
a. Titrate the infusion of 5% dextrose in water.
b. Administer prescribed subcutaneous DDAVP.
c. Assess the patient's overall hydration status every 8 hours.
d. Teach the patient to use desmopressin (DDAVP) nasal spray. ✔✔CORRECT
ANSWER✔✔ANS: B
Administration of medications is included in LPN/VN education and scope of
practice. Assessments, patient teaching, and titrating fluid infusions are
more complex skills and would be done by the RN.
Which information is most important for the nurse to communicate rapidly
to the health care provider about a patient admitted with possible syndrome
of inappropriate antidiuretic hormone (SIADH)?
a. The patient has a weight gain of 9 pounds.
b. The patient reports some dyspnea with activity.
c. The patient has a urine specific gravity of 1.025.
d. The patient has a serum sodium level of 118 mEq/L. ✔✔CORRECT
ANSWER✔✔ANS: D
, A serum sodium of less than 120 mEq/L increases the risk for complications
such as seizures and needs rapid correction. The other data are not unusual
for a patient with SIADH and do not indicate the need for rapid action.
After receiving change-of-shift report about the following four patients,
which patient would the nurse assess first?
a. A 31-year-old female patient with Cushing syndrome and a blood glucose
level of
244 mg/dL
b. A 70-year-old female patient taking levothyroxine (Synthroid) who has an
irregular pulse of 134
c. A 53-year-old male patient who has Addison's disease and is due for a
prescribed
dose of hydrocortisone (Solu-Cortef)
d. A 22-year-old male patient admitted with syndrome of inappropriate
antidiuretic hormone (SIADH) who has a serum sodium level of 130 mEq/L
✔✔CORRECT ANSWER✔✔ANS: B
Initiation of thyroid replacement in older adults may cause angina and
cardiac dysrhythmias. The patient's high pulse rate needs rapid investigation
by the nurse to assess for and intervene with any cardiac problems. The
other patients also require nursing assessment and/or actions but are not at
risk for life-threatening complications.
Which question will the nurse in the endocrine clinic ask to help determine a
patient's risk factors for goiter?
a. "How much milk do you drink?"
b. "What medications are you taking?"
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